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Health Journalism: Mara Gordon
28 Plays2 months ago
Dr. Mara Gordon is a writer and primary care physician for Cooper University Healthcare in Camden, NJ. Listen to Mara discuss her motivations for writing about healthcare, ways to create change in our healthcare system and the rationale for size-inclusive medicine. Check out Dr. Gordon's work here: https://sites.google.com/view/mara-gordon/
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Transcript
Introduction to The Wound Dresser Podcast
00:00:09
Speaker
You're listening to The Wound Dresser, podcast that uncovers the human side of healthcare.
Meet Dr. Mara Gordon
00:00:14
Speaker
I'm your host, John Neary.
00:00:21
Speaker
My guest today is Dr. Mara Gordon. Dr. Gordon is a primary care physician with Cooper University Healthcare care in Camden, New Jersey. She's also an assistant professor of family medicine at Cooper Medical School of Rowan University.
00:00:35
Speaker
In addition to her clinical and teaching duties, Dr. Gordon writes about primary care, size-inclusive medicine, and other healthcare topics for many news outlets, including National Public Radio, the Philadelphia Inquirer, and the New York Times.
00:00:50
Speaker
Dr. Abara Gordon, welcome to the Wound Dresser. Thank you so much for having me, John.
Writing as a Tool Against Burnout
00:00:55
Speaker
So you're ah a clinician, a teacher. I know you're also a mom. um So in in that busy schedule, why bother to to write about health care ah in the media space on top of all that you're already doing?
00:01:09
Speaker
Yeah, that's a great question. um It is certainly not for the money. I'll say that. mean, i i mean At the most basic level,
00:01:21
Speaker
For myself personally, it's really protective against burnout. um I find that it's a way to bring meaning to my work as a primary care doctor and as an educator um and try to sort of make sense of the crazy things that I see every day in our highly dysfunctional healthcare care system in the United States and um try to bring light to things that frustrate me or cause harm to my patients and and Yeah, try to try to make things better.
00:01:53
Speaker
um so I think I think that's at its core is it it helps me. um ah Yeah, it helps me feel like I have an outlet and a voice against all of the injustice that I see on a daily basis in in our health system.
Challenges in Health Journalism
00:02:12
Speaker
I mentioned some of the healthcare topics you touch on. Can you elaborate kind of ah like um why you pick certain things to write about and and what are in general kind of like the hot topics and in health journalism?
00:02:25
Speaker
Well, the second part of the question, i don't really know the answer to. I mean, I'm not a full-time health journalist. I think um think there's a lot of amazing health journalism out there, and there's a lot of mediocre health journalism out there. um And you know topics, it really depends on the publication and the intended audience. um And I mean, there's amazing, like really hard-hitting journalism. um In particular, I'll just highlight the work of Kaiser Health News, which I always turn to as sort of a source of like factual, evidence-based, accurate, timely health news that really targets issues of inequality and injustice in a way that I'm just in awe of and and really, really respect. um
00:03:09
Speaker
And Kaiser Health News, you may see their work in other publications. They partner with mainstream news publications. And sometimes you'll see like in the New York Times or on NPR, like, you know, this was done in partnership with Kaiser Health News. So you may see their work in,
00:03:22
Speaker
ah mainstream news outlets too, but they're, they're just really, i think, like the gold standard of excellent health journalism. um And, yeah, I mean, and there's lots of, you know, sort of news you can use, like 10 tips for, you you know, repopulating your gut flora or whatever, um or, you know, tips for sunscreen use in in the summer, or whatever. And, And all that stuff is really helpful. And I think there's a lot of good journalists doing um really evidence-based work, sort of promoting health tips to to their readership. um
00:03:57
Speaker
and And then, of course, there's health news and misinformation, um of which there's just like no end in sight, you know, all over the internet, ah just total information.
00:04:09
Speaker
i health misinformation that is not grounded in science. on Half of it, I don't know where it comes from. And, i you know, part of what interests me and my work in health journalism is, you know, combating that, right, and making sure that people have access to high quality, fact based, excellent, rigorous health news um so they can make decisions about their own personal health and sort of what kind of health behaviors they want to engage in.
00:04:38
Speaker
um But also, you know, how to access health care, how to navigate our health care system. Um, so that's your answer to the second part in terms of my favorite topics to write
Motivations Behind Writing Topics
00:04:48
Speaker
about. I mean, it really ah depends on what's kind of has a bee in my bonnet at the moment. um And what's driving me nuts in, ah in practicing primary care in, you know, the United States in 2024, really ranging from ah really ranging from you know, bureaucracy and high costs to, you know, access to reproductive health care has been a long standing interest of mine. And I've written about i pretty extensively from a variety of different angles.
00:05:17
Speaker
um And um yeah, I mean, there's just there's so many interesting things to explore no shortage of ideas, for sure. So when you feel like you're writing about ah reproductive health care or um bureaucracy or any of the things you mentioned, um like who's your who's your target audience? Are you really trying to hit health care professionals or a lay audience or a combination of both? And what kind of maybe response are you hoping for when when some of those folks, whoever you're you're targeting might be be reading your content?
00:05:54
Speaker
Yeah, I mean, I think it depends on the publication. um So ah npr which I have a longstanding relationship with, I did a fellowship there um when I finished residency in 2018.
00:06:07
Speaker
um And you know NPR has a very broad national audience, some international audience too, but I would say mostly US-based. And ah there they tend to be highly educated, lots of healthcare providers,
00:06:22
Speaker
listen to NPR and read NPR online. um So I think inherent in the audience, I'm targeting our people who work in healthcare care just because it's such a large part of our economy that ah you're bound to get some people working in healthcare when you are, um you know, trying to ah reach reach a broad audience in the United States. um Just so many people in our country do work in healthcare. care So it's sort of part of most mainstream audiences. And and Yeah, I mean, I think it depends on the article, right? Like different articles are targeted in different ways. um
00:06:57
Speaker
And some definitely have more of like the what we call service journalism component, which means that it's supposed to be sort of news you can use. So like I've done series on um you you know, how to how to find a primary care doctor, how to navigate specialty care, um how to navigate caregiving.
00:07:17
Speaker
Those are targeted at patients, right? And I, you know, of course doctors are patients too, is something I always like to say. I think sometimes we get a little overly ah dichotomized about doctor and patient being two separate categories and doctors are all patients too. But um but yeah, it's targeted at people sort of wanting to get some practical tips about navigating healthcare, right? um And that might be a different audience than um writing about a research study, um
00:07:49
Speaker
that i you know is about ah inappropriate use of an imaging, right? Like over imaging our patients and like too much testing that's going on and the the factors driving um sort of unnecessary, not clinically indicated imaging.
00:08:06
Speaker
um And that audience might be a little more healthcare oriented because ah doctors and nurses and and other folks working in healthcare are sort of the ones who might understand ah that phenomenon a bit more.
00:08:18
Speaker
Although, you know, it's relevant to patients too, of course, right? That like, you know, if you're getting unnecessary back x-rays or chest CTs, you know, of course, in the end, it affects patients in terms of the harms of unnecessary testing and also the costs get passed on to patients too. So, you know, ultimately, ultimately, it's all in service of our patients. um But each piece has sort of a slightly different target audience.
00:08:45
Speaker
Yeah, it sounds like in general, right? Like when you you're you're motivated to write, you're motivated to write an article that um it comes from a place of seeing something like that's not so great in our healthcare system and wanting to kind of, ah you know, voice your opinion or or kind of bring awareness to it.
Advocacy Through Journalism
00:09:02
Speaker
Yeah, like when you when you stand in that position, though, um I'm curious to hear like, I guess you have a number of options of how you want to address those things that maybe you don't like in our healthcare care system or aren't working so well.
00:09:15
Speaker
So you could, ah you know, write, ah write an article for say NPR, or you could conduct a research study, like, how do you how do you decide basically best to allocate your efforts? Totally. And I would add to that, I mean, there's so many ways to make change, right? So my interest has been in journalism. i would totally agree that research is another avenue for helping affect change in the U.S. healthcare system.
00:09:39
Speaker
There's advocacy work around sort of, you know, political channels like lobbying or, um you know, working with elected officials or working with professional societies to sort of draft, you bills or, um ah you know, a lot professional societies have sort of statements, like position statements, like, you know, they'll say that the American Academy of Family Physicians has a statement on, you know, XYZ issue, right? And that affects policy, that affects ah payments.
00:10:11
Speaker
um I mean, there's so many other ways to make change, right? Like getting involved in grassroots organizations, getting involved in um ah community-based work. I mean, they the teaching, right? Like teaching the the new generation of students. and I mean, all of these are avenues towards making change. And I think there's so many exciting ways to get involved. um And I think many of them can sort of sort of that same purpose that I discussed at the beginning, right? That like, it helps protect us against feeling, ah you know, like all of our work is in vain. It helps us feel like our work is making a difference when we feel like we have an outlet for um changing the injustices that we see. so
00:10:52
Speaker
All of those are great options. um For me, I mean, I've always just been interested in journalism. I was like a college journalist, um started working as a freelance ah writer when I was in medical school. um And on it's always sort of played to my skills. I think I really like reporting and interviewing people. um I find really fun and interesting and rewarding. um i think it's part of the same reason I like being a primary care doctor. Like I i just like talking to people.
00:11:23
Speaker
um And I felt like that was a skill that I was good at sort of, you know, talking, talking to people, understanding their stories, and then translating that into the written word has been something that has always i spoken to me as like a method of um advocacy and affecting change.
00:11:43
Speaker
um So that's, that's why i I like it. But I totally agree. I mean, there's so many avenues for, for advocacy work. And I think that I have so many friends and colleagues who are exploring tons of really interesting and exciting different ways of making change. And I think that's fabulous.
Separating Clinical Care and Advocacy
00:12:03
Speaker
So I'm curious, ah as as somebody who's like a, you know, a writer, um you know, healthcare is like often kind of viewed as this like neutral field, right? Like you're, you're ah attending to a patient, you're you're being there for them, like regardless of their situation.
00:12:19
Speaker
Like when you feel like it's ah like a physician's place to kind of like express their opinions? And when is it kind of like ah ah place to sort of, ah you know, be more reserved and kind of just be more about, ah you know, accommodating whatever a patient needs in a given moment?
00:12:34
Speaker
um I mean, to me, the line is between, you know, my sort of clinical interface and my advocacy and teaching roles. um I think, ah yeah, being being a good clinician is a skill that, you know, I'm continuing to work on and will continue to work on for the rest of my life. um and I don't think there's ever a point where you achieve good clinician status, right? It's it's always a work in progress. um But I, yeah, I mean, I want to be a great doctor to my patients. And um that is a really, really different skill, I think, than being ah ah teacher or being a writer or being a podcaster. um
00:13:19
Speaker
I think i being a clinician is and sort of about... putting the patient's needs first in some ways. And and I don't mean at all times, like,
00:13:33
Speaker
in the sense that we should give up all of our nights and weekends to respond to patient messages whenever they need us, right? um and And that's maybe a separate conversation about, um you know, how to prevent burnout and how to um achieve or attempt to achieve work-life balance. But um but i I mean, sort of within the bounds of an encounter with a patient, right? That it's it's not about me, it's about the patient. um And so letting letting them talk, letting them express their needs first and foremost, um letting them sort of set the agenda in many ways, not always, but that's sort of what I think about when I think about being a good clinician. um So I'm not there sitting and talking to my patients about, you know, what I have to pick up at the grocery store on the way home and, um you know, all the things that I might complain to a friend about or or complain to my spouse about, um right? and And that's sort of the same
00:14:30
Speaker
skill set ah as um not you know telling them which political candidate I'm going to vote for, whatever, that it's just, it's it's about putting them first, right? on That being said, I am really trying to talk to my patients about voting. um And this has been a goal I've set for myself up until the election in November.
00:14:50
Speaker
and don't know when this podcast is going to run. But um I yeah I feel like an encounter with a primary care physician is really a really intimate experience. But it's also with you know, I see 25, 30 patients a day. um And ah many of them are quite different for me, most of them are quite different from me. And so I don't, I would not say which candidate they should vote for that I don't think is, is appropriate. But I do, I do think a sort of reminder, like, hey, actually, you know, like, some the problems you're seeing about high prescription drug costs, or,
00:15:24
Speaker
um you know, surprise hospital bills, like actually those are political issues, like just a friendly reminder, like make sure you're registered to vote. um So that's been a fun sort of civic goal I have for myself. um But that feels really different than telling a patient, you know, who I'm voting for, who they should vote for, um which is not something I do.
00:15:46
Speaker
ah Yeah, yeah, I think I think oh I was just trying to get at the fact that like, like, you know, so you spend a lot of your day kind of with patients, like you said, in the clinical interface, and then um you might want to put your journalist hat on and kind of, you know, be a little more ah forthright about like the way you you think about things and and kind of like, whether it be politically or or whatnot. So Um, I, I guess, I don't know if those, those kinds of like roles, those identities ever are clashed or feel like incompatible or they they're kind of just things you compartmentalize and and keep separate.
Size-Inclusive Medicine and Patient Advocacy
00:16:20
Speaker
Um, that's an interesting question. i think, um, they, they haven't clashed much. Um, I, um,
00:16:31
Speaker
I mean, I do have an online presence ah as a writer. um And um I think particularly as I've started writing more about size inclusive medicine as sort of advocacy for people you know, ending fat phobia and healthcare that I've had a lot of patients come to see me specifically because they have found me online or have read something I've written or, ah you know, heard me on a podcast or whatever. um And so I think I'm getting more and more patients who are kind of like,
00:17:02
Speaker
aware of my writing and online presence um compared to, ah um you know, the last five years or so. um and And mostly that's been really positive. And, you know, I always tell patients, um you know, you like, you're welcome to follow me on social media. um i I mean, all of my online presence is really sort of geared at my professional identity. I don't have anything that is personal that is online um or publicly online. ah So, you know, it's not like they're friending my sort of private Facebook account or something. It's it's all like sort of ah connected to my professional identity. So I don't mind if if patients friend me and um or follow me or whatever. um
00:17:44
Speaker
And um so that's that's been kind of exciting in that I have patients who are sort of like more interested in and engaged in some of that advocacy work, but it hasn't um caused any problems.
00:17:58
Speaker
real quick, can you briefly just talk about like your interest in size inclusive medicine and and and when you're in clinic and you're trying to to set goals for for weight or metabolic health, like what those ah what those interactions look like?
00:18:13
Speaker
Yeah, so um i ah got interested in size inclusive medicine over the last five years or so, I would say. And it really stemmed from um Realizing that what I had been taught in medical school and residency, which was tell my patients to lose weight basically all the time, um was not working.
00:18:42
Speaker
And not only was it not working, it seemed to be causing harm, right? It seemed to be alienating my patients and making them feel judged and often not coming back to see me.
00:18:53
Speaker
Um, and I started noticing this pattern and, um, talk to other primary care friends about it. Like, And like, it really just stigmatizes people over and over again. it makes them feel, yeah, it makes them feel judged. It makes them feel like I'm not on their team.
00:19:13
Speaker
Um, what's going on. And I started reading more about some of the evidence base for primary care, based weight interventions like counseling, um which is basically like, you know, me saying, Hey, hop on the treadmill more often. um And there's a really, really weak evidence base for it.
00:19:32
Speaker
um And I was sort of shocked by this, like, Oh my gosh, like, you know, what I say doesn't, doesn't affect my patients. um Like they're actually, you know, in control of their own lives and their own bodies. um That was sort of humbling to realize And um there is a lot of evidence that it can cause a lot of harm, um that it really makes people disengage from primary care. It makes them delay care. It makes them not get recommended cancer screening tests, um makes them not come back to see us, you know, all all these things. Right. So I started thinking to myself, you know, like if this were a medication and it had such a weak evidence base for efficacy and actually had so many harms associated with it, you know, i wouldn't prescribe it.
00:20:15
Speaker
Um, and I, um, so I started experimenting with just not, not bringing up weight basically. Um, and, uh, a lot of patients still wanted to talk about it and that's totally fine. Um, you know, if, if it's, if it's something that they want to discuss with their doctor, I'm always happy to discuss whatever they want to talk about with me. Um, that's the fun of primary care is it's all on the table. Um, but, uh, that I wasn't really initiating conversations about patients' weight um
00:20:46
Speaker
And ah yeah overall, the results have been really, really positive. um And I've started writing and speaking about this issue publicly, and people are just coming out of the woodwork, um yeah sharing so many stories of difficult things that, you know, just really ah stigmatizing experiences that they've had in healthcare based on their weight.
00:21:09
Speaker
um Just that over and over again, healthcare care is like the most stigmatizing place that, people who live in bigger bodies go. um And that just made me feel really ashamed of my field and and feel like we really need to do better and um we need to step it up.
00:21:25
Speaker
So that's that's sort of how I got interested in size inclusive medicine um and how I define it is basically that I let patients set the agenda around body size issues and and let them bring it up. But it's not something I usually initiate.
00:21:40
Speaker
um Never say never. i mean, clinical medicine always keeps you on your toes. And um so I'm sort of allergic to any dogmatic statements about ah what exactly i do and don't do because there's, you know, always, always exceptions. um But in general, my practice is that, you know, if a patient wants to discuss their weight, I'm happy to, but it's usually not something that but I bring up.
Beyond Traditional Health Metrics
00:22:04
Speaker
I know you've ah kind of regarded BMI as maybe not so helpful of a tool to to measure metabolic health. Are there other, you know, qualitative or quantitative markers you like to use to kind of still, um you know, still let the the the patient guide the agenda for, like you said, like their body size, but but also you so that you have something to kind of present for in terms of metabolic health?
00:22:28
Speaker
Yeah, so I mean, this isn't just me. I mean, this is sort of the standard of care. I mean, the American Medical Association in 2023 came out and said, ah you know, like, we really shouldn't be using BMI to assess individual health.
00:22:40
Speaker
um So i med schools, clinical practice tend to be a little slower and getting up to speed with, you know, but The status quo um you know can take time to see change in medicine. But um I think that our field is really moving away from using BMI as sort of ah a way to assess an individual patient's health.
00:23:02
Speaker
um I use sort of for readily clinically available, you know, blood pressure, um evidence of glucose intolerance as sort of my two biggest sides. um I'll also use LDL cholesterol or just a lipid panel in general. And And ah sometimes visceral adiposity, which is basically like adipose tissue inside the internal organs, um that's not something we routinely screen for, but um will sometimes come up if a patient has had imaging, it'll be an incidental finding that they have like you know fatty liver disease, um or ah you know they might have abnormal liver function tests, and that will prompt um a liver ultrasound that then diagnosis them with fatty liver disease.
00:23:47
Speaker
So visceral adiposity isn't really in use as like a screening tool, but um often we'll we discover it with other testing. And and that can also be and ah an indicator that patients have abnormal metabolic disease that that we need to target.
Personal Interests and Leisure
00:24:07
Speaker
With that, it's time for a lightning round series of fast-paced questions to tell us more about you. um So who's one up and coming writer you like? Oh, great question. um I have so many answers to that. I'm just going to go with a book I read recently and really, really enjoyed, which was the novel called Burnham Wood by a New Zealand writer named, let me Google her. I believe it's her name is Eleanor Catten.
00:24:38
Speaker
um and don't if I'd call her up and coming because she won a major international award with her first novel a decade ago. Um, But Burnham Wood was just like the best novel I've read in a long time. It's about climate change and tech billionaires and psychology and generational differences. And it's so good.
00:25:01
Speaker
So Burnham Wood by Eleanor Catton. Check it out. What are your favorite summer and winter activities? um a Great question. um Summer activities. Hiking, swimming, biking.
00:25:13
Speaker
um i have a three-year-old son. We're trying to teach him to swim. he has a little bluey floaty that he likes to wear and um he's kind of getting the hang of it. um Just being outside as much as possible in the summer. In the winter, i really like baking I was a pandemic sourdough person and have continued the tradition.
00:25:39
Speaker
What's your go-to cocktail or evening beverage? i Seltzer. Always and forever. I'm a seltzer addict. ah What is your favorite pair of shoes?
00:25:55
Speaker
I am going to go with a tie between um New Balance sneakers and Birkenstocks. And maybe that's a summer winter answer.
A Vision for Justice in Healthcare
00:26:06
Speaker
and lastly, in ah a sense or so, what's one change you'd like to see in healthcare?
00:26:11
Speaker
Oh, man, how do I answer in one sentence? I think um
00:26:20
Speaker
reconnecting with a sense of justice, right? That like, what what we should do is we in healthcare should be pursuing justice, health justice, right? um and um And we have a lot of work to do.
Conclusion and Sign-off
00:26:38
Speaker
Dr. Amara Gordon, thanks so much for joining the show. and Thank you so much for having me, John. I really appreciate it
00:26:54
Speaker
Thanks for listening to The Wound Dresser. Until next time, I'm your host, John Neary. Be well.